Emergency Responder Health Monitoring and Surveillance (ERHMS)


Significant gaps and deficiencies continue to exist in health monitoring and surveillance of the 3.5 million emergency response workers, such as, police, fire, emergency medical personnel, cleanup, repair, restoration, and recovery workers. Emergency response workers must be protected from the hazardous conditions that disasters and other emergencies create, whether natural such as a hurricane or earthquake or a result of human action such as the April 15, 2013 tragedy in Boston, MA. A plan for monitoring the health and conducting surveillance of emergency responders is essential to ensure their health and safety.

Recognizing this, NIOSH worked with the U.S. National Response Team (NRT), and several federal agencies, state health departments, labor unions, and volunteer emergency responder groups to develop the Emergency Responder Health Monitoring and Surveillance™ (ERHMSTM) framework. The ERHMSTM framework provides recommendations for protecting emergency responders during small and large emergencies in any setting. It is for use by all who are involved in the deployment and protection of emergency responders, including: incident command staff, response organization leadership, health, safety and medical personnel, and emergency responders.

ERHMS framework
Disaster-related Exposure Assessment and Monitoring (DREAM) Course

The DREAM Course is offered several times a year. Visit the Disaster Related Exposure Assessment and Monitoring – Center for Domestic Preparedness (dhs.gov) webpage for more information.

Course Description: This 4-day (32 hours) training course provides knowledge and experience in assessing, monitoring, and tracking health effects among emergency responders and community members before, during, and after a disaster. These effects can occur from exposures to chemical, biological, radiological, nuclear, and explosive, and other hazards. The course trains attendees on disaster epidemiologic tools developed by the U.S. Agency for Toxic Substances and Disease Registry (ATSDR) and the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health. These tools combine Emergency Responder Health Monitoring and Surveillance (ERHMS)™, Assessment of Chemical Exposure (ACE), and Epi CASE (Case Assessment Symptom and Exposure). Additional training includes disaster response and a capstone exercise.